Heather Yakin: Mental-health plan needs accountabilty

The state Office of Mental Health and Gov. Andrew Cuomo's administration want to restructure mental health care in New York.

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By Heather Yakin

recordonline.com

By Heather Yakin

Posted Jul. 17, 2013 at 2:00 AM

By Heather Yakin
Posted Jul. 17, 2013 at 2:00 AM

» Social News

The state Office of Mental Health and Gov. Andrew Cuomo's administration want to restructure mental health care in New York.

They're promising the moon and the sun, a brand-new day with "centers of excellence" in forensic mental health and a new focus on enhanced community services.

The problem is that these are the same promises we've heard for the past 40 years. Somehow, those promises always seem to get broken as soon as someone decides that the savings gleaned from cuts in mental-health spending can be used to feather the nest of some other interest group with a whole lot more lobbying power and appeal than people with mental illness.

We get another round of cuts to services and hospital closures and job losses, without adding community services to pick up the slack.

The OMH/Cuomo plan to close some psychiatric hospitals and replace them with regional centers supplemented by community-based treatment has drawn praise from patient advocacy groups. But it's praise tempered with the warning that those community outpatient services are absolutely necessary.

The plan is to consolidate 24 state psychiatric hospitals into 15 regional centers with 24 affiliated outpatient hubs in communities with a history of high usage, while preserving jobs. The savings from the closings/consolidations would be reinvested in community-based services.

Those are "several steps in the right direction," according to representatives from the Mental Health Assoaiation in New York State and the New York State Association of Psychiatric Rehabilitation Services.

Community-based care is a good thing, and it's where most people who use the public mental-health system go. According to the state, about 715,000 New Yorkers used the mental-health care system in 2012; of those, 10,000 got care in inpatient hospitals. The state spends roughly $1.3 billion per year on those 10,000 inpatients compared with $5.3 billion on the other 705,000.

Again, the advocates are behind "realignment," but they want the people who actually need and use those resources to have a say in how the system is retooled.

The U.S. Supreme Court ruled that people with mental illness must be treated in the least-restrictive environment possible. Locking people away, absent some clear and compelling reason, is inhumane and counterproductive.

"Closing state psychiatric hospitals is only half of the equation," said Briana Gilmore of NYAPRS. "Without adequate reinvestment into recovery-oriented, rehabilitative services, people will not be given the opportunity to recover fully in the community."

The new state plan promises accountability in care; access to affordable housing, education and jobs; early detection of illness and community treatment.